NICOLE SUZETTE SOPER (NPI# 1073969044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073969044 |
| Entity Type | Individual |
| Full Name | NICOLE SUZETTE SOPER |
| Credential | APN FNP-BC |
| Practice Address |
302 W Hay St Decatur IL 62526-4167 |
| Mailing Address |
201 E Madison St Springfield IL 62702-5131 |
| Practice Telephone | 2175458000 |
| Mailing Telephone | 2175453787 |
| Mailing Fax Number | 2177623949 |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2019-11-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 041330758 | IL | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209014230 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1709 S Fairview Ave, Decatur, IL 62521 | 2174292551 | 2174292942 |
| Street Address |
302 W HAY ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-4167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063411304 | Lee G Endsley | Urology | 302 W Hay St, Ste 200, Decatur, IL 62526-4167 | 2005-07-19 |
| 1629490628 | John W. Newlin, M.d., LLC | Internal Medicine | 302 W Hay St, Suite 130, Decatur, IL 62526-4167 | 2014-01-09 |
| 1811322001 | Sneha Kumar | Family Medicine | 302 W Hay St, Suite 110, Decatur, IL 62526-4167 | 2013-09-06 |
| 1104196294 | Jeremy Good | Physician Assistant | 302 W Hay St, Suite 200, Decatur, IL 62526-4167 | 2012-01-05 |
| 1255587176 | Midwest Neurology Associates, S.c. | Specialist | 302 W Hay St, Suite Ll110, Decatur, IL 62526-4167 | 2008-08-12 |
| 1699962209 | Steven E Weber, Md, Ltd | Surgery | 302 W Hay St, Suite 205, Decatur, IL 62526-4167 | 2007-09-27 |
| 1376737346 | Sudhakar Konda | Family Medicine | 302 W Hay St, Lower Level Suite 110, Decatur, IL 62526-6304 | 2007-08-31 |
| 1942333067 | Midwest Neurology Associates, S.c. | Specialist | 302 W Hay St, Suite Ll110, Decatur, IL 62526-4167 | 2007-03-14 |
| 1326191503 | Allen Bernard Devleschoward Jr. | Specialist | 302 W Hay St, Ste 210, Decatur, IL 62526-4167 | 2007-01-19 |
| 1528164951 | George Albert Liu | Surgery | 302 W Hay St, Ste 205, Decatur, IL 62526-4167 | 2006-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729965 | Jamie Mclemore | Nurse Practitioner | 17619 Hwy 58 North, Decatur, TN 37322-3732 | 2020-10-30 |
| 1790383776 | Angela Tope Adeleke | Nurse Practitioner | 3185 Georgian Woods Cir, Decatur, GA 30034-5105 | 2020-10-13 |
| 1417564147 | Jigna Patel | Nurse Practitioner | 1963 Don Juan Ln, Decatur, GA 30032-4218 | 2020-09-27 |
| 1659983856 | Emilie Carsell Mathias | Nurse Practitioner | 2208 N Crossing Way, Decatur, GA 30033-4175 | 2020-08-19 |
| 1275151078 | Tiffanie Marshall Mcguire | Nurse Practitioner | 2042 Beltline Rd Sw Ste B101, Decatur, AL 35601-5571 | 2020-07-08 |
| 1922623610 | Anastasiya A Drogoul | Nurse Practitioner | 2675 N Decatur Rd Ste 404, Decatur, GA 30033-6133 | 2020-06-09 |
| 1174156244 | Anne Marie Strickland | Nurse Practitioner | 3109 Vicksburg Pl Sw, Decatur, AL 35603-3107 | 2020-02-18 |
| 1174161822 | Allison Leanne Hall | Nurse Practitioner | 304 W Hay St Ste 312, Decatur, IL 62526-4170 | 2019-12-12 |
| 1396387866 | Elizabeth Nichole Mathews | Nurse Practitioner | 2301 S Fm 51 Ste 100, Decatur, TX 76234-3864 | 2019-10-16 |
| 1861040479 | Oladunni Funmi Faminu | Nurse Practitioner | 2701 N Decatur Rd # 2400, Decatur, GA 30033-5918 | 2019-08-27 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.